多排螺旋CT对肝脏孤立性坏死结节的诊断价值

The diagnostic value of multi-slice spiral CT in solitary necrotic nodule of liver

目的探讨肝脏孤立性坏死结节的CT表现特征,以提高诊断准确率。方法对6例肝脏孤立性坏死结节进行常规CT平扫及增强扫描,全部病例均经病理证实,观察并记录病灶的大小、形态、边界、密度及增强特点。结果病灶多位于肝表面和肝浅表实质内,呈圆形或类圆形,边界清楚,最小的1.7cm×2.1cm,最大的4.9cm×3.7cm,CT平扫4例为低密度影,1例为等密度影,其中1例内部密度不均匀,可见片状等密度影,增强后5例病灶在动脉期、门静脉期及延迟期呈内部无增强表现,1例病灶内部见多发斑块状与肝实质等密度强化灶,病灶边缘见细环形强化且在延迟期更明显。结论病灶内部三期基本无强化和周边可伴有或不伴有环形强化为肝脏孤立性坏死结节主要CT表现,MSCT是诊断肝脏孤立性坏死结节有价值的检查方法。

Objective To explore the CT features of solitary necrotic nodule（SNN）and to raise the accuracy rate of diagnosis.Methods Both plain and dynamic enhanced CT scanning were performed in 6 cases proved by pathology.The size,shape,margin,density and enhanced features of each lesion were observed and recorded.Results The SNN mostly located in the liver surface and superficial liver parenchyma and the lesions were round or oval.The margin was clearly defined.4 cases of them appeared hypodensity and one of them appeared isodensity on plain CT.The other showed homogeneous hypodensity and appeared flaky slightly hyperdensity.No obvious enhancement was found expect that multiple patchy showed delayed enhancement in one case on post-contrast CT images,while,the capsule of these lesions were demonstrated delayed enhancemnet.Conclusion On CT images,SNN is shown general characteristics that there should be no contrast enhancement within the lesion and/or circular enhancement surrounding lesion.MSCT is a valuable examination to diagnose SNN.